Limited coverage criteria – cladribine

Last updated on April 23, 2026

Special Authority requests can now be submitted online. It's simple and quick!

Generic name		cladribine
Strength & form		10 mg tablet

Special Authority criteria	Approval period
As first-line monotherapy for the treatment of adults (18 years of age and older) with relapsing-remitting multiple sclerosis (RRMS) who meet ALL of the following criteria: Diagnosis according to the current clinical criteria and magnetic resonance imaging (MRI) evidence AND Special Authority request is submitted by a neurologist from a designated MS clinic³ AND Patient is ambulatory with or without aid (Expanded Disability Status Scale [EDSS] of 6.5 or less)	2 years (2 treatment courses)^1,2

Special Authority criteria

Approval period

As first-line monotherapy for the treatment of adults (18 years of age and older) with relapsing-remitting multiple sclerosis (RRMS) who meet ALL of the following criteria:

Diagnosis according to the current clinical criteria and magnetic resonance imaging (MRI) evidence

AND

Special Authority request is submitted by a neurologist from a designated MS clinic³

AND

Patient is ambulatory with or without aid (Expanded Disability Status Scale [EDSS] of 6.5 or less)

2 years (2 treatment courses)^1,2

Practitioner exemptions

A Collaborative Prescribing Agreement (CPA) (PDF, 144KB) is available to neurologists specializing in MS whose primary place of practice is a designated MS clinic. Neurologists who have signed a CPA are not required to submit a Special Authority request form for coverage
Each CPA must be signed by the neurologist who is requesting coverage (not a delegate)

Special notes

¹Cladribine is given as 2 treatment courses over 2 years (cumulative dose of 3.5 mg/kg body weight over 2 years). Each treatment course (1.75 mg/kg body weight per year) consists of 2 treatment weeks, one at the beginning of the first month and one at the beginning of the second month of the respective year. A treatment week is given for 4 or 5 days. Total duration of treatment over the 2 years is 4 weeks (2 weeks per year)
²PharmaCare coverage is limited to two courses of treatment per lifetime. The efficacy of cladribine for treatment duration beyond 2 years has not been established
³The patient is under the care of a specialist (neurologist from a designated MS clinic) who has experience in the diagnosis and management of RRMS

Special Authority request form(s)

Did you find what you were looking for?

The B.C. Public Service acknowledges the territories of First Nations around B.C. and is grateful to carry out our work on these lands. We acknowledge the rights, interests, priorities, and concerns of all Indigenous Peoples - First Nations, Métis, and Inuit - respecting and acknowledging their distinct cultures, histories, rights, laws, and governments.

More topics